odd_job/app/worker/view/agent/agent_join.html

<div class="layui-fluid">
    <div class="layui-row layui-col-space15">
        <div class="layui-col-md12">
            <div class="layui-card">
                <div class="layui-card-header">申请成为代理</div>
                <div class="layui-card-body" pad15>

                    <div class="layui-form layui-form-pane" lay-filter="LAY-demand-demandform-edit">

                        <div class="layui-form-item">
                            <label class="layui-form-label"><span style="color:#f90c05;">*</span>姓名</label>
                            <div class="layui-input-block">
                                <input type="text" name="realname" value="" lay-verify="required" autocomplete="off" class="layui-input">
                            </div>
                        </div>
                        <div class="layui-form-item">
                            <label class="layui-form-label">手机号</label>
                            <div class="layui-input-block">
                                <input type="text" name="mobile" value="" lay-verify="phone" placeholder="请输入..."
                                       autocomplete="off" class="layui-input">
                            </div>
                        </div>
                        <div class="layui-form-item" id="LAY-demand-demandform-edit-areapicker">
                            <label class="layui-form-label"><span style="color:#f90c05;">*</span>省市区</label>
                            <div class="layui-input-inline">
                                <select name="province" class="province-selector" data-value="" lay-filter="province-2"
                                        lay-verify="required">
                                    <option value="">请选择省</option>
                                </select>
                            </div>
                            <div class="layui-input-inline">
                                <select name="city" class="city-selector" data-value="" lay-filter="city-2" lay-verify="required">
                                    <option value="">请选择市</option>
                                </select>
                            </div>
                            <div class="layui-input-inline">
                                <select name="district" class="district-selector" data-value="" lay-filter="district-2"
                                        lay-verify="required">
                                    <option value="">请选择区</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-form-item">
                            <label class="layui-form-label"><span style="color:#f90c05;">*</span>详细地址</label>
                            <div class="layui-input-block">
                                <input type="text" name="address" value="" lay-verify="required" placeholder="请输入..."
                                       autocomplete="off" class="layui-input">
                            </div>
                        </div>
                        <div class="layui-form-item">
                            <label class="layui-form-label">身份证号</label>
                            <div class="layui-input-block">
                                <input type="text" name="idcard" lay-verify="identity" value="" placeholder="请输入...."
                                       autocomplete="off" class="layui-input">
                            </div>
                        </div>
                        <div class="layui-form-item">
                            <label class="layui-form-label"><span style="color:#f90c05;">*</span>推荐人</label>
                            <div class="layui-input-block">
                                <input type="text" name="recommender" value="" lay-verify="required" placeholder="请输入...."
                                       autocomplete="off" class="layui-input">
                            </div>
                        </div>
                        <div class="layui-form-item">
                            <div class="layui-input-block">
                                <input type="button" lay-submit lay-filter="LAY-demand-demandform-edit-submit" value="确认提交" class="layui-btn">
                            </div>
                        </div>
                    </div>

                </div>
            </div>
        </div>
    </div>
</div>


<script>
    layui.config({
        base: '/static/echoui/' //静态资源所在路径
    }).extend({
        index: 'lib/index' //主入口模块
    }).use(['index', 'form', 'set', 'layedit', 'laydate', 'upload', 'inputTags', 'layarea'], function() {
        var $ = layui.$,
            setter = layui.setter,
            admin = layui.admin,
            layedit = layui.layedit,
            laydate = layui.laydate,
            form = layui.form,
            inputTags = layui.inputTags,
            upload = layui.upload,
            layarea = layui.layarea;
        form.render();

        inputTags.render({
            elem: '#inputTags',
            content: [],
            aldaBtn: true,
            count: 6,
            done: function(value) {}
        });

        layarea.render({
            elem: '#LAY-demand-demandform-edit-areapicker',
            // data: {
            // 	province: '河南省',
            // 	city: '郑州市',
            // 	district: '金水区',
            // }
        });


        form.on('submit(LAY-demand-demandform-edit-submit)', function(obj) {
            var index = parent.layer.getFrameIndex(window.name);
            admin.req({
                url: setter.baseWorkerUrl + 'agent/agent_join',
                data: obj.field,
                type: 'post',
                done: function(res) {
                        layer.msg(res.msg, {icon: 1});

                    parent.layui.table.reload('LAY-demand-demandlist-table'); //重载表格
                    parent.layer.close(index);
                }
            });
        });
    });
</script>